TY - JOUR
TI - Association between exposome score for schizophrenia and functioning in first-episode psychosis: Results from the Athens first-episode psychosis research study
AU - Erzin, G.
AU - Pries, L.-K.
AU - Dimitrakopoulos, S.
AU - Ralli, I.
AU - Xenaki, L.-A.
AU - Soldatos, R.-F.
AU - Vlachos, I.
AU - Selakovic, M.
AU - Foteli, S.
AU - Kosteletos, I.
AU - Nianiakas, N.
AU - Mantonakis, L.
AU - Rizos, E.
AU - Kollias, K.
AU - Van Os, J.
AU - Guloksuz, S.
AU - Stefanis, N.
JO - Psychological Medicine
PY - 2021
VL - null
TODO - null
SP - null
PB - Cambridge University Press
SN - 0033-2917
TODO - 10.1017/S0033291721004542
TODO - null
TODO - Background Evidence suggests that environmental factors not only increase psychosis liability but also influence the prognosis and outcomes of psychotic disorders. We investigated temporal and cross-sectional associations of a weighted score of cumulative environmental liability for schizophrenia - the exposome score for schizophrenia (ES-SCZ) - with functioning in first-episode psychosis (FEP). Methods Data were derived from the baseline and 1-month assessments of the Athens FEP Research Study that enrolled 225 individuals with FEP. The Global Assessment of Functioning (GAF) and the Personal and Social Performance Scale (PSP) were used to measure social, occupational, and psychological functioning. The ES-SCZ was calculated based on the previously validated method. Results ES-SCZ was associated with the total scores of GAF and PSP at baseline and 1-month assessments. These findings remained significant when accounting for several associated alternative explanatory variables, including other environmental factors (obstetric complications, migration, ethnic minority), clinical characteristics (duration of untreated psychosis, symptom severity, previous antipsychotic use), and family history of psychosis, demonstrating that the association between ES-SCZ and functioning is over and above other risk factors and cannot be explained by symptom severity alone. Functioning improved from baseline to 1-month assessment, but no significant ES-SCZ-by-time interaction was found on functioning, indicating that functioning changes were not contingent on ES-SCZ. Conclusions Our findings suggest that rather than a predictor of functional improvement, ES-SCZ represents a stable severity indicator that captures poor functioning in early psychosis. Environmental risk loading for schizophrenia (ES-SCZ) can be beneficial for clinical characterization and incorporated into transdiagnostic staging models. Copyright © The Author(s), 2021. Published by Cambridge University Press.
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